Fallopian Research Articles

Geometry of obstructed pathway regulates upstream navigational pattern of sperm population.

Sperm navigation through the complex microarchitecture of the fallopian tube is essential for successful fertilization. Spatiotemporal structural alteration due to folded epithelium or muscle contractions in the fallopian tube changes the geometry of the sperm pathways. The role of structural complexity in sperm navigational patterns has been investigated for single sperm cells but has not been fully addressed at the population level. Here, we studied the dynamics of the navigation of a bull sperm population through obstructed pathways mimicking the architecture of the female reproductive tract. We observed that slightly tapered barriers enhance navigation by 20% compared to straight pathway; however, tapered barriers with a 90° angle restrict sperm passage. We demonstrated sperm cooperation while passing through a tapered pathway in a low-viscosity medium under elevated shear rates. These findings propose a fresh perspective on how sperm move through the fallopian tube, suggesting that the convoluted pathways' shape influences sperm navigation locally.

Efficacy of 4-dimensional hysterosalpingo-contrast sonography and X-ray hysterosalpingography in infertility.

To assess and compare efficacy of 4-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) and X-ray hysterosalpingography (HSG) for fallopian tube examination. Clinical data of patients with suspected tubal infertility, who underwent examinations in Qingdao Women and Children's Hospital from September 2021 to December 2023, were retrospectively analyzed. Of them, 40 patients received laparoscopy and dye test+ 4D-HyCoSy (4D-HyCoSy group), and 36 patients received laparoscopy and dye test +HSG (HSG group). The study included clinical data of 76 patients with a total of 149 fallopian tubes. Using laparoscopy and dye test observations as the gold standard, 4D-HyCoSy and X-HSG examinations identified 39 blocked tubes, 69 tubes with partial patency, and 41 tubes with patency. Compared with laparoscopy and dye test, the diagnostic concordance rate of 4D-HyCoSy was 70.51% (55/78), Kappa=0.546 (P<0.05); and the diagnostic concordance rate of HSG was 69.01% (49/71), Kappa=0.516 (P<0.05). Sensitivity, specificity, and accuracy of the diagnosis of obstruction, partial patency, and patency were comparable in the two groups (P>0.05). The incidence of pain and adverse reactions were significantly lower in the 4D-HyCoSy group compared to the HSG group (P<0.05). While both 4D-HyCoSy and HSG have high efficacy in fallopian tube examination, and are similarly accurate in evaluating tubal blockage, 4D-HyCoSy is associated with lower incidence of pain, and reduced rate of adverse reactions.

First-in-human phase I trial of the bispecific CD47 inhibitor and CD40 agonist Fc-fusion protein, SL-172154 in patients with platinum-resistant ovarian cancer

BackgroundSL-172154 is a hexameric fusion protein adjoining the extracellular domain of SIRPα to the extracellular domain of CD40L via an inert IgG4-derived Fc domain. In preclinical studies, a murine equivalent...

No Bacterial Biomass Detected in Tissue From Patients With Ovarian Cancer and Serous Tubal Intraepithelial Carcinomas Using 16S rDNA Sequencing.

The ovarian oncobiome is subject to increasing scientific focus, but a potential link between bacterial dysbiosis and ovarian carcinogenesis remains controversial. Our primary aim was to characterize the bacterial microbiota in epithelial ovarian cancer samples. Secondarily, we aimed to compare results from the bacterial microbiota in formalin-fixed, paraffin-embedded ovarian tissue samples from 194 patients with epithelial ovarian cancer, fallopian tube tissue samples from 16 patients with serous tubal intraepithelial carcinomas and in benign fallopian tube tissue samples from 25 patients. Bacterial abundance was investigated by means of 16S rDNA Next Generation Sequencing. The 16S rDNA sequencing run produced a very low number of bacterial reads. Only seven samples displayed bacterial reads above 5000. Validation of detected bacterial reads by qPCR was negative and indicative of results being background amplification. Our results indicate no amount of bacterial biomass in the ovarian cancer, benign fallopian tube and in the samples with serous tubal intraepithelial carcinomas. The findings underline the importance of validating results from bacterial microbiota studies with additional technical assays before any conclusion may be drawn.

Comparative Metabolomics in Liver Reveals Eggshell Translucency Formation Using LC-MS Analysis

Eggshell translucency is the common problem on eggshell that become more severe with age. They are important because it influence consumer preferences and the economic value of eggs. The reason for the eggshell translucency is currently believed to be the eggshell membrane (ESM). In this study, we screened translucency eggs and normal eggs and used metabolomics to study liver metabolism in different eggshell translucency and discuss important liver lipids and phosphatidyl metabolites. Liver samples were taken for Liquid Chromatograph Mass Spectrometer (LC-MS) during the formation of eggshell membranes in hens, that is, when eggs form eggshell membranes in the oviduct isthmus. The results showed that we identified two essential metabolic pathways through differential metabolite pathway analysis, which were glycine, serine, and threonine metabolism related to amino acids metabolism and the PPAR metabolic pathway related to lipid metabolism. Furthermore, this study helps us understand the process of translucency egg production in poultry. This laid the foundation for in-depth research on eggshell translucency. These results may and provide support for future breeding.

Microshunt preserflo revision by anterior vitrectomy

Aims/Purpose: To describe a clinical case involving the obstruction of a glaucoma drainage device (GDD) caused by the presence of vitreous in the anterior chamber, a rare cause of this type of obstruction.Methods: We report the case of a 79‐year‐old patient with pseudoexfoliative secondary open‐angle glaucoma in the left eye. Despite being under hypotensive treatment with four active principles, the patient showed poor intraocular pressure (IOP) control and progression of glaucomatous damage. It was decided to implant a PreserFlo MicroShunt. During the preoperative examination, vitreous strands and capsular debris were evident in the anterior chamber, probably due to zonular dehiscence secondary to previous cataract surgery. Although the PreserFlo MicroShunt implantation and drainage bleb were performed correctly, the IOP remained elevated in the first week. Obstruction of the valvular tube by the vitreous strand was identified as the cause of GDD failure.Initially, conservative treatment with YAG laser vitreolysis was attempted but was not effective. Therefore, a new surgical intervention consisting of anterior vitrectomy, revision of the valvular tube and drainage bleb was proposed. During surgery, triamcinolone acetonide was used to stain the vitreous, as well as brilliant blue to check the patency of the valvular tube. The leakage bleb and the most distal portion of the tube were checked by conjunctival dissection and Tenon's capsule.Results: As a result of the surgical intervention, the patient was able to achieve the target IOP. Future revisions are expected to confirm stabilization of glaucomatous damage.Conclusions: In conclusion, the vitreous and capsular debris should be removed by performing a wide anterior vitrectomy prior to GDD placement if necessary. YAG laser vitreolysis may be a temporary solution, but anterior vitrectomy ensures long‐lasting patency of the drainage device.

Oral contraceptive use is associated with a reduction in the physical size of fallopian tube p53 signatures

Oral contraceptive use is associated with a reduction in the physical size of fallopian tube p53 signatures

Prevalence of Homologous Recombination Deficiency Among Women with Newly Diagnosed Ovarian, Primary Peritoneal, and/or Fallopian Tube Cancer: The International HALO Study

Prevalence of Homologous Recombination Deficiency Among Women with Newly Diagnosed Ovarian, Primary Peritoneal, and/or Fallopian Tube Cancer: The International HALO Study

A Multimodal Model Based on Transvaginal Ultrasound-Based Radiomics to Predict the Risk of Peritoneal Metastasis in Ovarian Cancer: A Multicenter Study.

This study aimed to develop a predictive model for peritoneal metastasis (PM) in ovarian cancer using a combination radiomics and clinical biomarkers to improve diagnostic accuracy. This retrospective cohort study of 619 ovarian cancer patients involved demographic data, radiomics, O-RADS standardized description, clinical biomarkers, and histological findings. Radiomics features were extracted using 3D Slicer and Pyradiomics, with selective feature extraction using Least Absolute Shrinkage and Selection Operator regression. Model development and validation were carried out using logistic regression and machine learning methods RESULTS: Interobserver agreement was high for radiomics features, with 1049 features initially extracted and 7 features selected through regression analysis. Multi-modal information such as Ascites, Fallopian tube invasion, Greatest diameter, HE4 and D-dimer levels were significant predictors of PM. The developed radiomics nomogram demonstrated strong discriminatory power, with AUC values of 0.912, 0.883, and 0.831 in the training, internal test, and external test sets respectively. The nomogram displayed superior diagnostic performance compared to single-modality models. The integration of multimodal information in a predictive model for PM in ovarian cancer shows promise for enhancing diagnostic accuracy and guiding personalized treatment. This multi-modal approach offers a potential strategy for improving patient outcomes in ovarian cancer management with PM.

Ovulation sources ROS to confer mutagenic activities on the TP53 gene in the fallopian tube epithelium

IntroductionEpidemiological studies have implicated ovulation as a risk factor for ovarian high-grade serous carcinoma (HGSC) at the initiation stage. Precancerous lesions of HGSC commonly exhibit TP53 mutations attributed to DNA deamination and are frequently localized in the fallopian tube epithelium (FTE), a site regularly exposed to ovulatory follicular fluid (FF). This study aimed to assess the mutagenic potential of FF and investigate the expression levels and functional role of activation-induced cytidine deaminase (AID) following ovulation, along with the resulting TP53 DNA deamination. MethodsThe mutagenic activity of FF toward premalignant and malignant FTE cells was determined using the hypoxanthine phosphoribosyl transferase (HPRT) mutation assay with or without AID knockdown. The sequential activation of AID, including expressional induction, nuclear localization, DNA binding, and deamination, was determined. AID inducers in FF were identified, and the times of action and signaling pathways were determined. ResultsFF induced AID activation and de novo FTE cell mutagenesis in two waves of activity in accordance with post-ovulation FF exposure. The ERK-mediated early activity started at 2 min and peaked at 45 min, and the NF-κB-mediated late activity started at 6 h and peaked at 8.5 h after exposure. ROS, TNF-α, and estradiol, which are abundant in FF, all induced the two activities, while all activities were abolished by antioxidant cotreatment. AID physically bound to and biochemically deaminated the TP53 gene, regardless of known mutational hotspots. It did not act on other prevalent tumor-suppressor genes of HGSC. ConclusionThis study revealed the ROS-dependent AID-mediated mutagenic activity of the ovulatory FF. The results filled up the missing link between ovulation and the initial TP53 mutation and invited a strategy of antioxidation in prevention of HGSC.

WOMEN GENITAL TUBERCULOSIS: A STUDY OF TWO CASES AT MOHAMMED VI UNIVERSITY HOSPITAL IN MARRAKECH

Objective: Tuberculosis is a contagious infectious disease caused by the Mycobacterium tuberculosis. It is often pulmonary but in rare cases extrapulmonary such as genital tuberculosis. The aim of this study is to report two cases of genital tuberculosis at the Mohammed VI University Hospital. Case presentation: We report the case of two patients who consulted for different symptomatologies, one for chronic pelvic pain and the second one for primary infertility of 9 years. The investigations carried out led to the diagnosis of genital tuberculosis with endometrial and fallopian tubes localization respectively, which was confirmed by histological examination. Results: Case 1:60-year-old female patient with no previous history of tuberculosis, menopaused, multiparous, consulted for pelvic pain associated with weight loss. Clinical examination was without any particularity. Pelvic ultrasound revealed a 1.5cm glandular-cystic endometrial thickening. NOVAK endometrial biopsy yielded ten millilitres of purulent fluid and endometrial tissue. Cytological examination of the purulent fluid revealed an inflammatory cytology with a predominance of altered leukocytes and no suspicious cells. Pathological examination of the endometrial tissue showed epithelioid and giganto-cellular granulomatous inflammation, with caseous necrosis, suggesting genital tuberculosis. Patient was referred to tuberculosis care center, where an antibacillary treatment was initiated according to protocol 2 ERHZ and 4RH. Case 2: Patient aged 33, genitally active, consulted for primary infertility of 9 years with no other associated signs. The clinical examination was without any particularity. Paraclinical examinations, (hormonal assessment, pelvic ultrasound and the husbands sperm analysis), were without any particularity. The hysterosalpingography noted bilateral tubal obstruction. A laparoscopic surgical procedure revealed a caseous collection in the fallopian tubes, and histological examination was in favour of tuberculosis. Patient was referred to tuberculosis care center for treatment (2ERHZ/4RH protocol), and In Vitro Fertilization was proposed. Conclusion: Genital tuberculosis is a rare pathology, with great clinical variability, so its incidence remains underestimated.

CERVICAL TUBERCULOSIS MIMICKING MALIGNANCY: CASE REPORT

Cervical tuberculosis is an uncommon condition that often mimics cervical cancer in clinical presentations, leading to potential misdiagnosis. The definitive diagnosis is typically established through biopsy, which allows for the identification of characteristic histopathological features. Medical management is the primary approach for treating cervical tuberculosis, involving the use of antitubercular therapy tailored to the patients needs. However, the prognosis for young women diagnosed with this condition can be complicated by the risk of infertility, especially in cases where there is concurrent involvement of the uterine tubes.

Ovarian cancer risk reduction by salpingectomy during non-gynaecological surgery: scoping review.

Ovarian cancer is the leading cause of death among gynaecological cancers. The identification of the fallopian tube epithelium as the origin of most ovarian cancers introduces a novel prevention strategy by removing the fallopian tubes during an already indicated abdominal surgery for another reason, also known as an opportunistic salpingectomy. This preventive opportunity is evidence based, recommended and established at the time of gynaecologic surgery in many countries worldwide. To expand interest among surgeons in performing a salpingectomy during non-gynaecological surgery, the aim of this review is to identify knowledge gaps during those surgeries. A scoping review was performed following the PRISMA-Scoping Review (ScR) checklist. PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) database and Cochrane Library were systematically searched from inception to November 2024. Trial registers were searched for ongoing trials. All studies reporting original data on salpingectomy during non-gynaecological surgery were included. Outcomes were provided narratively. Eighteen studies were identified reporting on the implementation, surgical feasibility, patients' perspectives, physicians' knowledge and cost-effectiveness of an opportunistic salpingectomy during non-gynaecological surgery. Population-level data indicate that an opportunistic salpingectomy is rarely performed in non-gynaecological surgeries. High success rates and no complications of an opportunistic salpingectomy were observed during bariatric surgery and cholecystectomies. However, performing an additional salpingectomy appeared more time-consuming. Patients had strong interest in information on and willingness to undergo opportunistic salpingectomy. Cost-effectiveness analysis encourages opportunistic salpingectomy use, as models show reduced ovarian cancer incidence and mortality rate while being cost-effective. Opportunistic salpingectomy during non-gynaecologic surgery appears to be a promising method to prevent ovarian cancer. Implementing such a strategy will require education of multiple surgical disciplines, training and resolution of organizational issues.

Comparison of pregnancy success rates in ICSI (Intracytoplasmic Sperm Injection) success rates in cases of male and female infertility at the Graha Amerta Fertility Clinic, RSUD Dr. Soetomo Hospital, Surabaya, for the period 2018 – 2022: A Literature Revi

Infertility, defined as the inability to conceive after one year of unprotected intercourse (WHO, 2012), affects 8–10% of couples worldwide, equivalent to 50–80 million couples, with 2 million new cases annually (WHO, 2013). In Indonesia, 10–15% of the 39.6 million reproductive-age couples face infertility, with primary causes including sperm issues (35%), ovulatory disorders (20%), fallopian tube blockages (20%), endometriosis (20%), and idiopathic factors (10%). The prevalence is rising both globally and domestically, with infertile women in the U.S. projected to reach 7.7 million by 2025. Assisted reproductive technologies like IVF achieve a success rate of 40–50%, while ICSI, a more advanced technique, offers higher success rates, particularly for cases of poor sperm quality (Wulaningsih, 2021; Aurel et al., 2023). However, routine ICSI use without clear indications should consider associated risks and costs (ASRM, 2020). ICSI success rates have improved from 44.6% in 2014 to 59.5% in 2023 (Palermo et al., 2014; Batha et al., 2023). Further research is needed in Indonesia to comprehensively compare ICSI success rates between male and female infertility cases.

ENDOSCOPIC TUBAL CANALIZATION AS AN ALTERNATIVE TO IVF: AN OUTCOME ANALYSIS

Tubal infertility is a significant contributor to subfertility worldwide, particularly in low- and middle-income countries like Pakistan, where limited access to advanced reproductive technologies poses significant challenges. Endoscopic tubal canalization offers a minimally invasive and cost-effective alternative to in vitro fertilization (IVF) for managing proximal tubal occlusion. Objective: This study aimed to evaluate the efficacy and safety of endoscopic tubal canalization as an alternative to IVF, focusing on procedural success rates, pregnancy outcomes, and associated complications in women with proximal tubal infertility. Methods: A prospective cohort study was conducted on 72 women of reproductive age diagnosed with proximal tubal occlusion using hysterosalpingography (HSG) or laparoscopy. Patients underwent endoscopic tubal canalization, and outcomes were assessed in terms of procedural success (unilateral or bilateral tubal patency), pregnancy rates (spontaneous and intrauterine insemination), and complications. Statistical analysis was performed to compare results with existing literature and evaluate the safety profile. Results: The overall success rate of tubal canalization was 83.3% (60/72), with unilateral patency achieved in 29.1% (21/72) and bilateral patency in 54.1% (39/72). The failure rate was 16.6% (12/72). The procedure was associated with a low complication rate, with only 4% (3/72) of patients experiencing tubal perforation. Pregnancy success was observed in 29.1% (21/72) of patients, with 52.3% (11/21) achieving spontaneous conception and 47.6% (10/21) conceiving via intrauterine insemination. Among pregnancies, 90.4% were intrauterine, while 9.5% were ectopic. The findings align with international studies, demonstrating comparable success rates and safety profiles. Conclusion: Endoscopic tubal canalization is an effective and safe alternative to IVF for managing proximal tubal infertility in resource-limited settings. It provides a cost-effective solution with favorable success rates and minimal complications, particularly for patients with socioeconomic constraints. This study contributes valuable data specific to the Pakistani population and highlights the need for further research to assess long-term outcomes and live birth rates.

Airway microbial landscape in patients with primary ciliary dyskinesia – a pilot study

Primary ciliary dyskinesia (PCD) is a rare hereditary disease belonging to the group of ciliopathies. PCD is caused by a defect in the ultrastructure of the cilia of the respiratory epithelium and similar structures (sperm flagella, fallopian tube villi, ventricular ependyma) with a prevalence of 1:10,000 to 1:30,000 people. One of the main problems associated with this condition is frequent recurrent bacterial infections, which lead to decreased lung function and the development of bronchiectasis. The aim was to study the microbial landscape of the respiratory tract of patients with PCD. Methods. We studied the medical history and bacteriological assays of 170 throat, nasal, and sputum samples from 64 patients diagnosed with PCD. Bacteriological methods, RT-PCR, and MALDI-TOF mass spectrometry were used to identify microorganisms. Results. The bacteriological assay identified 46 bacterial species, 4 viral species, and representatives of 2 fungal genera. The predominant bacteria were Staphylococcus aureus (62.5%) and Pseudomonas aeruginosa (26.6%). The identified fungi were Candida spp. and Aspergillus spp. Viruses (Adenoviridae, Coronaviridae, Rhinoviridae) were detected in 7 patients in association with representatives of normal microflora and clinically significant microorganisms such as S. aureus, Klebsiella pneumoniae, P. aeruginosa. Achromobacter spp., Stenotrophomonas maltophilia, Acinetobacter spp., and Moraxella spp. were isolated in individual cases in patients of all age groups. Conclusion. The respiratory microflora was characterized by a species diversity of pathogens and was mixed in 79.7% of patients. A viral-bacterial associations was observed in 10.9% of patients. S. aureus was the predominant pathogen in the group of children and adolescents (58.3% and 82.6%, respectively), whereas P. aeruginosa predominated (52.9%) in the adult patients.

Ruptured Ectopic Pregnancy With Properly Placed Intrauterine Device: A Case Report

The intrauterine device (IUD) is a popular contraception choice for women worldwide, due to a low failure rate. Although it is highly effective, it does not eliminate the risk for an ectopic pregnancy. An ectopic pregnancy occurs when a previously fertilized ovum implants outside of the uterus that can become life-threatening. In this case study, a female patient presented to a freestanding emergency department with abdominal pain, without bleeding. A sonogram showed a normal uterus with an IUD in the correct location, normal ovaries, as well as significant fluid in the pelvis and abdomen. A pregnancy test was ordered after imaging, which came back as a positive result. The patient’s blood pressure as well as her complete blood count continued to decrease, and she underwent surgery that revealed a ruptured ectopic pregnancy in the right fallopian tube and hemoperitoneum. This case highlights the importance that a properly placed IUD, without issue, does not exclude the possibility of an ectopic pregnancy.

Clinicopathological features and prognostic analysis of synchronous mucinous metaplasia and neoplasia of the female genital tract

Objective: Synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT) occurring at multiple sites during the same period of time is extremely rare, and the aim of this study was to investigate the clinicopathologic features of SMMN-FGT and its relationship with prognosis. Methods: We retrospectively analyzed the clinicopathological features and follow-up records of 25 cases of SMMN-FGT diagnosed from January 2012 to October 2022 in the case database of Obstetrics and Gynecology Hospital of Fudan University. Results: The median age at onset was 46 years old, respectively. Clinical manifestations included irregular vaginal bleeding or drainage, pelvic pain, and ovarian cysts, etc. Germline genetic test confirmed Peutz-Jeghers syndrome (P-J syndrome) in two patients. All patients underwent surgery, and 13 patients had postoperative adjuvant radiotherapy and/or chemotherapy. The most frequent site of lesion was the cervix (21 cases), with 11, 10 and 16 cases occurring in the endometrium, fallopian tubes and ovaries, respectively. Six cases involved three sites simultaneously, and only one case had all four sites involved at the same time. Among the 9 cases with P53 mutation phenotype, 6 cases had gastric-type mucinous adenocarcinoma, 2 cases had lobular endocervical glandular hyperplasia, and 1 case had mucinous adenocarcinoma, whereas all the minimally deviated adenocarcinomas had wild phenotype of P53. The median follow-up time was 59 months, during which 3 cases died and 6 cases developed local recurrence or distant metastasis. According to our analysis, postoperative recurrence or metastasis was correlated with the FIGO stage of the disease, the number of lesion sites and the severe degree of the uterine lesions (P＜0.05). Conclusions: SMMN-FGT has a relatively good clinical prognosis, and even advanced patients can benefit from surgery and adjuvant therapy. In young patients, the ovaries may be preserved if no evidence of lesions are seen after adequate evaluation. In SMMN-FGT, gastric-type mucinous adenocarcinoma occurring in the cervix may have a better prognosis than gastric-type mucinous adenocarcinoma of the cervix alone, so the accurate diagnosis of SMMN-FGT is critical for clinical management.

Study protocol for Adaptive ChemoTherapy for Ovarian cancer (ACTOv): a multicentre phase II randomised controlled trial to evaluate the efficacy of adaptive therapy (AT) with carboplatin, based on changes in CA125, in patients with relapsed platinum-sensitive high-grade serous or high-grade endometrioid ovarian cancer

IntroductionAdaptive ChemoTherapy for Ovarian cancer (ACTOv) is a phase II, multicentre, randomised controlled trial, evaluating an adaptive therapy (AT) regimen with carboplatin in women with relapsed, platinum-sensitive high-grade serous or...

Epidermal growth factor receptor ligands enriched in follicular fluid exosomes promote oncogenesis of fallopian tube epithelial cells

BackgroundIncessant ovulation is the main etiologic factor of ovarian high-grade serous carcinomas (HGSC), which mostly originate from the fallopian tube epithelium (FTE). Receptor tyrosine kinase (RTK) ligands essential for follicle development and ovulation wound repair were abundant in the follicular fluid (FF) and promoted the transformation of FTE cells. This study determined whether RTK ligands are present in FF exosomes and whether epidermal growth factor receptor (EGFR) signaling is essential for oncogenic activity.MethodsThe FF of women undergoing in vitro fertilization was fractionated based on the richness of exosomes and tested for transformation toward FTE cells under different RTK inhibitors. EGFR ligands in FF exosomes were identified, and downstream signaling proteins in FTE cells were characterized.ResultsThe transforming activity of FF was almost exclusively enriched in exosomes, which possess a high capacity to induce anchorage-independent growth, clonogenicity, migration, invasion, and proliferation of FTE cells. EGFR inhibition abolished most of these activities. FF and FF exosome exposure markedly increased EGFR phosphorylation and the downstream signal proteins, including AKT, MAPK, and FAK. Multiple EGF family growth factors, such as amphiregulin, epiregulin, betacellulin, and transforming growth factor-alpha, were identified in FF exosomes.ConclusionsOur results demonstrate that FF exosomes serve as carriers of EGFR ligands as well as ligands of other RTKs that mediate the transformation of FTE cells and underscore the need to further explore the content and roles of FF exosomes in HGSC development.